Abstract 4559: Long-term Safety and Efficacy of Zotarolimus-eluting Stent versus Sirolimus-eluting Stent or Bare Metal Stent in Patients With STEMI Who Underwent Primary Percutaneous Coronary Intervention
Backgrounds: The long-term efficacy and safety of zotarolimus-eluting stent (ZES) has not been proved in patient with STEMI who are undergoing primary percutaneous coronary intervention (PCI) as compared with sirolimus-eluting stent (SES) or bare metal stent (BMS).
Methods and results: We evaluated consecutive 2,456 patients with STEMI underwent primary PCI by means of Korea Acute Myocardial Infarction Registry. Median follow up period is 343 days (range 1– 455). Number of the patients used SES is 1727, ZES is 447 and BMS is 282. Among three groups there were a few differences such as previous ischemic heart disease history, stent length and stent diameter (ZES 7.2% vs. SES 10.3% vs. BMS 12.8%, P=0.037, 23.82±5.460 vs. 26.21±6.282 vs. 22.00±5.513, P<0.0001, 3.23±0.459 vs. 3.13±0.344 vs. 3.48±0.267, P<0.0001, respectively). And SES was more often implanted when performing intervention of left anterior descending artery (SES 76.0% vs. ZES 17.1% vs. BMS 6.9%, P<0.0001). In cox regression analysis, using ZES or SES was independently associated with the incidence of major adverse cardiac event (MACE) (Hazard ratio 0.591, 95% confidence interval 0.440 – 0.793, P=0.002). The using of ZES or SES showed lower incidence of MACE (figure 1⇓), cardiac death and target vessel revascularization with target lesion revascularization (ZES 8.0% vs. SES 7.3% vs. BMS 14.0%, P<0.0001, 4.6% vs. 4.5% vs. 8.0%, P=0.012, 3.2% vs. 2.3% vs. 5.1%, P=0.009, respectively).
Conclusions: In patients with STEMI who received primary PCI, implantation of ZES significantly reduced long-term MACE and showed similar outcomes as compared with SES.